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HEALTH

Lockdowns and vaccine scepticism – how France and Italy are struggling to get Covid under control

While many countries are at least talking about easing Covid-related rules, in France and Italy people are bracing for extra restrictions. Clare Speak in Bari and Emma Pearson in Paris discuss the situation in their respective countries.

Lockdowns and vaccine scepticism - how France and Italy are struggling to get Covid under control
France and Italy are both struggling with a lockdown exit strategy. Photo: Jean-Pierre Clatot/AFP

What is the situation now?

France – the whole of France is under a 6pm-6am curfew and bars, restaurants, cafés, gyms, cinemas, theatres and tourist sites have all been closed since October. In February the French government ruled out, for now, a third lockdown, but extra restrictions including weekend lockdowns are being imposed in areas that have a high level of the virus.

Italy – There’s a nationwide curfew in place from 10pm-5am and a ban on non-essential travel between all regions. Other rules vary by region depending on local infection rates. In areas designated higher-risk ‘red’ and ‘orange’ zones, bars, restaurants, gyms, cinemas, theatres, museums and most shops are shut. For now, the government hopes this system will mean Italy can avoid another national lockdown.

Emma: So Clare, France has in the last couple of weeks changed its strategy from national rules to regional restrictions. We tried this over the summer and it didn’t seem to work so I’m a bit sceptical, but it seems like Italy has been following this strategy for some time – is it working?

The southern French city of Nice is now under weekend lockdown because of the high number of cases. Photo: Valery Hache/AFP

Clare: I think a lot of people were quite sceptical here too when Italy’s tiered system was first introduced in November. I have to admit I thought we’d all be back under lockdown by now. But four months later it’s still going. 

But is it working? The government seems to think so. The health minister said this week that it’s staying in place as it’s the only way to respond fairly to the different situations in each part of the country. The aim overall though seems to be keeping the infection rate at a manageable level, rather than squashing the curve. New infections and the death toll had been slowly, steadily dropping overall since the tiered system came in, but the infection rate is now rising again. There are concerns that we’re at the start of a feared ‘third wave’ but it’s still too early to be sure.

READ ALSO: Where and how much are coronavirus cases rising in Italy?

A lot of towns and provinces in Italy are being put under local lockdowns now because of the rising numbers and local outbreaks – is anything like that happening in France?

Emma: Yes, we’re seeing very much the same thing. In France this week 20 départements, including Paris, have been labelled ‘alert’ areas because of the rising number of cases and some places including Nice and a large stretch of the Riviera have been put on a weekend lockdown.

Overall cases in France have been on what they call a ‘high plateau’ of about 20,000 new cases a day since mid December, but there are some areas where cases are rising really rapidly and that is worrying authorities. There’s also a lot of concern about new variants of the virus – more than half of all cases are now new variants.  What’s the situation with case numbers in Italy?

Clare: New variants are the big issue in Italy right now too. Up to 50 percent of new cases are thought to be due to variants in some regions, and they’re the cause of a lot of the outbreaks that are leading to the local lockdowns.

It’s interesting that cases in France have plateaued under the national restrictions. The same had been happening here for about two months, with overall cases staying at around 12,000 a day. But it’s now up to about 17,000 and rising.

Bars are open until 6pm in some regions of Italy. Photo: Vincenzo Pinto/AFP

Emma: We seem to test a lot in France, the tests are free for everyone and available via the pharmacy, so I’m never sure exactly how seriously to take international comparisons of case numbers – what’s the situation with getting a test in Italy? Is it easy to do and do people get tested regularly?

Clare: It’s easy to do if you pay for it. Testing varies by region, but here in the south of Italy at least you can’t often be tested under the national health service. The only people who can access free tests are teachers, healthcare staff or other key workers. I don’t think many people get tested regularly – private testing costs at least €25 a time. I’ve only had it done once and it cost €60. I know it’s more expensive in some countries, like the UK for example if you need a test for travel, but the cost is still a barrier for a lot of people.

Emma: So what exactly is open in Italy now?

Clare: It depends on your regional restrictions. So if you’re in a red zone, pretty much everything is closed except essential shops. But a lot of things are actually open if you’re in a lower-risk area, including museums and art galleries.

Right now my region is a ‘yellow’ zone which means bars and restaurants can open too – until 6pm, anyway. This was supposed to stop people gathering for a spritz in the evenings, but in practice it just means aperitivo hour has moved forward to 5pm.

Emma: You have bars! I’m so jealous, all our bars have been closed since October. On the other hand though, all French schools have been doing in-person teaching since May, they stayed open right through the second lockdown and apparently French pupils have had the highest number of in-person teaching days in Europe over the last year. 

The government made a choice to keep the hospitality and leisure sectors closed in order to be able to open schools, a decision I obviously applaud in the abstract, even if I could kill for a Martini – what’s the situation with schools in Italy?

READ ALSO ANALYSIS Was France right to keep its schools open during the pandemic?

Clare: The Italian government said it aimed to do the same thing late last year. So most schools were able to teach in person, except for high school classes, who’ve been on at least 50 percent distance learning. But lately it’s all become a lot more complicated.

More regions have been moving schools to distance learning, and more businesses have been allowed to reopen. This week the government said that all schools now need to close in red zones, as the concern is that new variants are affecting young people more. So it seems like they’ve completely changed the strategy here now.

Emma: I guess we should maybe talk vaccines too, this is increasingly a sore subject in France as our rollout of the programme is pretty glacial.

We’ve managed to give 3 million people their first jab, which is miles behind countries like the UK and Israel (although we have more than 1 million people fully vaccinated with the second dose too which is actually higher than the UK) and people are getting increasingly frustrated about the slow pace.

READ ALSO 6 reasons why France’s vaccine rollout is so slow 

Even those who are in the priority over 75s group tell us it’s often really hard to get an appointment at the local vaccine centre. How’s it going in Italy?

Clare: I think we’re in a similar boat when it comes to vaccines. Italy has given about 4.5 million shots and has 1.5 million people fully vaccinated. At this rate, most adults wouldn’t be fully vaccinated until December. So there’s a lot of frustration with it here too. But there is hope, as the new government has just announced plans to speed things up significantly – the aim now is to have about half of the population vaccinated by June.

Some of the delays are caused by bureaucratic problems though, and then there’s also the fact that some people in the few priority groups who are eligible actually refuse the vaccine.

Emma: Is vaccine scepticism a problem in Italy? We seem to have really high levels of it in France, around 50 percent of people are telling polls that they won’t definitely be vaccinated.

Clare: Yes, it actually is quite a big problem here too –  the government has made 10 vaccines mandatory in the past few years because vaccination rates were falling so much. With the Covid vaccine, there seems to be really widespread confusion about safety and effectiveness.

Italy’s public health messaging on this has not been particularly clear or reassuring so far, so that will definitely need to change if the government is going to reach their vaccination targets.

Emma: Yes, communication in France has also not been good, particularly about the AstraZeneca vaccine. I think the government has been wary about doing too much of a PR ‘push’ around vaccines in case it just makes people even less inclined to get them – since a lot of French people like nothing more than telling their government where to stick it! But the more hands-off approach doesn’t seem to be working either.

Let’s hope both our governments get their act together by the summer . . .

Member comments

  1. It’s incorrect to say tests are more expensive in the UK. They are free and available on self-referral to anyone with symptoms and to people who has been advised that they were in close contact with someone with the virus. It’s only people who choose to get a test without symptoms or exposure that pay anything, e.g.because you want to travel or to get early release from self-isolation after arriving in the UK.

    Also 1M people with the second dose when first dose numbers are so low is nothing to brag about, it’s just 1m people left at far higher risk for longer than needed and remaining more able to spread the disease to others. Initial timelines are based on the pre-approval trial practices which is all the pharma companies had at the time to base recommendations and efficacy statements on. We now have real world data and far larger sample sizes to make more educated decisions with – and those studies are showing time and time again that such tight timeless are not needed. Governments should be criticised not praised when they put lives at risk by not following the science as it improves – particularly when it’s based on politicking. Needless delays on vaccines, particularly the first dose, are literally killing people.

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ITALIAN ELECTIONS

What will a right-wing election victory mean for abortion rights in Italy?

The right-wing parties poised to win Italy’s upcoming general elections have a history of denouncing abortion. Could a new conservative government threaten reproductive rights in Italy?

What will a right-wing election victory mean for abortion rights in Italy?

When Italians go to the polls on September 25th, a coalition of three right-wing parties – Giorgia Meloni’s Brothers of Italy, Matteo Salvini’s League and Forza Italia, led by former premier Silvio Berlusconi – are widely expected to win the vote and secure the opportunity to form Italy’s next government.

READ ALSO: Your ultimate guide to Italy’s crucial elections on Sunday

With all three parties to the right of centre – by quite some way, in the case of Brothers of Italy and the League – activists are concerned about what Italy’s most socially conservative government in years could mean for women seeking to access abortions, as they have had the legal right to do here for over four decades.

Here’s what Italian law says about abortion, what the right-wing alliance has promised it will – or won’t – change, and what all this could mean for people in need of abortion care in Italy.

What is Italy’s law on abortion now?

Abortion – formally referred to in Italian as interruzione volontaria di gravidanza or IVG, ‘voluntary termination of pregnancy’ – has been legal in Italy since 1978.

Passed after years of protests and several other failed bills, Legge 194 (‘Law 194’) decriminalized the procedure and entitled women to request it for any reasons of physical or mental health within the first 90 days after conception.

Women can continue to seek an abortion after 90 days if a significant foetal abnormality is present, or if continuing the pregnancy would endanger the woman’s life.

READ ALSO: The long road to legal abortion in Italy

The procedure is offered free of charge to those who qualify for public healthcare in Italy.

To access it, women first must consult a doctor and discuss options “to help her to overcome the factors which would lead her to have her pregnancy terminated”.

If the patient continues to affirm her original choice, she will be issued a certificate either stating that the termination is urgent and can be carried out immediately, or, if it is not deemed urgent, that she can seek the procedure after a obligatory seven-day wait.

Campaigners in front of a banner reading ‘Don’t touch law 194’. Photo by FABRIZIO VILLA / AFP

In reality, the wait for an appointment is likely to be far longer. Law 194 also affirms the right of health workers to refuse to carry out abortions on the grounds of “conscientious objection”. 

This has translated into serious gaps in coverage across Italy, with some facilities staffed mostly or even entirely by personnel who decline to deliver abortion services.  

READ ALSO: Why abortions in Italy are still hard to access – despite being legal

In fact, a majority of gynaecologists in Italy – 64.6 percent, according to 2020 figures from the Ministry of Health – are registered objectors, as well as 44.6 percent of anaesthesiologists and 36.2 percent of non-medical staff at health facilities. 

In several parts of the country, including the regions of Sicily, Basilicata, Abruzzo, Molise and the province of Bolzano, the percentage of gynaecologists refusing to perform abortions is over 80 percent.

These doctors are probably out of step with public opinion in Italy. A 1981 referendum gave voters the opportunity to reject the new abortion law; 68 percent of them voted to keep it. 

More recently, an Ipsos poll conducted earlier this year found that 73 percent of people surveyed in Italy said abortion should be legal in all or most cases.

What election promises has Italy’s right-wing alliance made about abortion?

No doubt sensing the lack of appetite for a full-scale repeal of Italy’s abortion law, the right-wing coalition has made clear that that’s not on its agenda. 

Abortion doesn’t get a single mention in the joint platform put forward by the Brothers of Italy, League and Forza Italia. 

Law 194 does appear in the Brothers of Italy programme, which promises “full application” of the legislation, “starting with prevention” of abortion.

To this end, it pledges the allocation of funds to support single and economically disadvantaged women to carry pregnancies to term, a proposal echoed by the League and presented by both parties as part of a broader drive to reverse Italy’s plummeting birth rate.

The League’s platform also calls for implementation of Law 194’s provisions on the “effective promotion of life”, including by involving non-profit groups – presumably Catholic and other pro-life ones – in pre-abortion counselling.

Forza Italia, historically the most centrist of the three, hasn’t broached the subject at all. 

READ ALSO: Salvini vs Meloni: Can Italy’s far-right rivals put differences aside?

Both Meloni and Salvini have faced questions on the campaign trail about their position on abortion, given previous comments calling abortion “a defeat for society” (Meloni), loudly professed Catholicism (Salvini) and support for European allies who have restricted access to abortion, such as Hungarian Prime Minister Viktor Orban (both). 

“Law 194 isn’t to be touched,” Salvini told reporters this week. “The last thing Italy needs is a country divided and arguing over the laws in place – which can be improved and updated, but certainly not scrapped.”

Meloni, meanwhile, told a recent interviewer that “I never said I want to modify Law 194, but that I want to apply it”. That includes supporting women who feel obliged to abort for economic or practical reasons, she said – as well as supporting health workers who refuse to provide the procedure. 

Why are activists worried a new right-wing government could threaten abortion rights in Italy?

The problem is that Law 194 perhaps does need an overhaul if it is to guarantee access to safe, legal abortions across Italy. 

Those who support women’s right to choose have long complained that the 44-year-old law – whose primary objective, the Italian Health Ministry’s website states, “is the social protection of motherhood and the prevention of abortion” – is not fit for purpose.

A demonstrator holds a sign reading ‘free to choose’ at a rally in defence of Italy’s abortion law. Photo by FABRIZIO VILLA / AFP

Law 194 “does not establish in a strong sense women’s right to choice and self-determination: it establishes when access to it is permitted and granted,” Chiara Lalli, a writer and academic with a focus on abortion, told Il Post

The multiple doctor visits, mandatory counselling session and seven-day “reflection” period are attempts to interfere with women’s decisions, activists say. 

READ ALSO: ‘Ugly act’: Outrage in Italy over discovery of foetus graves marked with women’s names

Separately, watchdogs including the United Nations Human Rights Committee, Human Rights Watch and the Council of Europe’s committee of social rights have flagged the high rates of conscientious objectors as a persistent barrier to abortion access in Italy.

While authorities are supposed to ensure that women can access terminations and that objecting doctors can’t refuse care beyond the procedure itself, with no mechanisms to enforce these requirements specified in the existing law, in practice women report facing long delays or being denied assistance altogether. 

In the past, both Brothers and Italy and the League have resisted attempts to help the problem, such as by recruiting specifically non-objecting doctors.

While these problems are longstanding, there have been attempts in recent years to put more obstacles between women and abortions – mainly from regional or municipal politicians, who tend to be more explicit in their opposition than those on the national stage.

Many of these have come from members of the three main right-wing parties, which together have governed 14 of Italy’s 20 regions for the past two years.

And with each region largely in charge of managing its own public health service, regional governments have the power to make decisions that significantly affect how and where women can access abortions.

In Le Marche, headed by the Brothers of Italy, the regional government refused to implement 2020 national guidelines from the Ministry of Health that would have extended the window for medical abortions from seven to nine weeks and made it possible for women to obtain abortion pills in outpatient clinics and family planning centres instead of going into hospital. 

Abruzzo, whose council is also led by Brothers of Italy, as well as Piedmont and Umbria, two regions governed by the League, resisted the change too.

Priests join an anti-abortion demonstration on May 21st 2022 in central Rome. The placard reads “Human Rights are born in the womb”. Photo by Alberto PIZZOLI / AFP

Piedmont has further allowed anti-abortion groups to set up stands in public hospitals, and councillors have proposed funnelling public funds to groups that would pay women not to abort

The League-run council in Verona declared it a “pro-life city” and called for funding for anti-abortion projects to be written into the town budget, as well as authorizing anti-abortion groups to display promotional material in council buildings. 

In the wider region of Veneto, such groups are allowed to offer family counselling services alongside those providing neutral information – a move the League’s manifesto suggests extending when it talks about involving non-profits in “the promotion of life”. 

To those who support abortion, it all starts to look like a pattern. “As soon as a right-wing council takes charge, it seems like these issues are at the top of the agenda,” Beatrice Brignone, head of the small left-wing party Possibile, told L’Espresso back in 2020.

READ ALSO: Why an Italian woman was forced to go to 23 hospitals to have an abortion

With threats to abortion access in Italy emerging locally and unchecked at national level, some activists say they would in fact welcome putting Law 194 up for debate under the next government.

“As much to better implement it as to make the necessary modifications … it is time to begin an informed discussion on abortion and free ourselves from the prejudice that the law is untouchable,” comments the Luca Coscioni Association, which advocates for freedom of scientific research and backs abortion rights.

Meloni and her allies have already made clear that such a discussion will not be among their priorities if they win this weekend. 

What do other parties say about abortion?

Abortion isn’t an issue for either the centrists Italia Viva or Azione, nor for the populist Five Star Movement.

The centre-left Democratic Party promises the full application of Law 194 throughout the country, without going into further details.

The only concrete proposals come from much smaller parties on the left: Possibile proposes establishing a quota of at least 60 percent of non-objecting staff in each health facility, as well as tracking the service provided by each region and punishing those who fail to meet minimum standards. 

The Greens and Left Alliance wants to change recruitment rules to hire more non-objecting medical staff, while +Europa suggests partnering with private clinics to expand access and making medical abortion more widely available as an outpatient procedure.

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